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2010-04-19 07:59:39
The brains of children with attention-deficit disorders respond to on-the-spot
rewards in the same way as they do to medication, say scientists.
A Nottingham University team measured brain activity as children played a
computer game, offering extra points for less impulsive behaviour.
Their findings, published in Biological Psychiatry, could mean lower doses of
drugs such as Ritalin in severe cases.
But they warn teachers and parents may often struggle to give instant rewards.
Estimates vary, but it is believed that up to 5% of children in the UK have
some form of attention-deficit hyperactivity disorder (ADHD).
This can lead to behavioural problems including impulsive actions, fidgeting
and poor attention span, and can affect a child's academic and social progress.
Our study suggests that both types of intervention may have much in common in
terms of their effect on the brain
Professor Chris Hollis, Nottingham University
In severe cases, stimulant drugs such as Ritalin, which act on parts of the
brain associated with attention and behaviour, can be given.
In addition, parents are often asked to try to influence the child's actions
directly by rewarding positive behaviour and making sure that there are
negative consequences if a child behaves badly.
Research has suggested that, unlike in non-ADHD children, these incentives and
disincentives only work well if delivered on the spot, as opposed to later in
the day or week.
The Nottingham team wanted to look at the effects of this "behaviour therapy"
in the brain of the child.
They devised a computer game in which children had to "catch" aliens of a
certain colour, while avoiding aliens of a different colour.
The game was designed to test the children's ability to resist the impulse to
grab the wrong sort of alien.
To test whether incentives made a difference, in one variant of the game the
reward for catching the right alien was increased fivefold, as was the penalty
for catching the wrong one.
Lower doses
Activity in different parts of the brain was monitored using an
electroencephalogram (EEG).
They found that the incentives helped the children perform better at the game,
although not to the same extent as the child's normal dose of Ritalin.
However, the EEG revealed that both were "normalising" brain activity in the
same regions.
Professor Chris Hollis, who led the research, said that the combination of
drugs and incentives produced the best results, and might mean children with
ADHD could take lower doses of drugs while maintaining control of their
behaviour.
He said: "Although medication and behaviour therapy appear to be two very
different approaches of treating ADHD, our study suggests that both types of
intervention may have much in common in terms of their effect on the brain.
"Both help normalise similar components of brain function and improve
performance."
However, he conceded that it might not always be practical to use behavioural
therapy.
"We know that children with ADHD respond disproportionately less well to
delayed rewards - this could mean that in the 'real world' of the classroom or
home, the neural effects of behavioural approaches using reinforcement and
rewards may be less effective."
Andrea Bilbow, from the National Attention Deficit Disorder Information and
Support Service (Addiss), echoed this: "It means you have to be in front of
that child 24/7, and you just can't do that - teachers and schools would have
to totally change the way they deal with this."
Story from BBC NEWS:
http://news.bbc.co.uk/go/pr/fr/-/2/hi/health/8625741.stm
Published: 2010/04/18 23:40:39 GMT